ISSN: 2161-0932
Hugo Maia Jr, Clarice Haddad, Wilson SD dos Santos Junior, Nathanael Pinheiro, Julio Casoy, Genevieve Coelho
Objective: To demonstrate whether a combination of resveratrol with pinus pinaster extract increases the inhibitory effect of oral contraceptives on aromatase expression in the eutopic endometrium of patients with endometriosis.
Methods: The study population consisted of 175 patients referred to this center for diagnostic hysteroscopy with endometrial biopsy. The patients were divided into five groups according to the treatment they were receiving at the time of hospital admission: Group A: 48 patients with a history of pelvic pain and/or infertility and no hormonal treatment; Group B: 36 patients using oral contraceptives in extended regimens; Group C: 30 patents using oral contraceptives with resveratrol; Group D: 15 patients using only the pinus pinaster extract with resveratrol; and Group E: 46 endometriosis patients who had been using oral contraceptives together with 100 mg of a pinus pinaster extract and 30 mg of resveratrol daily. Aromatase expression was determined in the endometrium by immunohistochemistry.
Results: The mean number of cases in which aromatase expression was positive in the endometrium decreased significantly in oral contraceptive users (Group B). In Group E, the combination of oral contraceptives with pinus pinaster extract and resveratrol further decreased the number of cases in which there was positivity for aromatase expression. In Group D, the mean percentage of positive aromatase expression was significantly lower compared to Group A (controls) (p=0.01) but not significantly different from Group B. In patients using oral contraceptives with resveratrol (Group C), the percentage of patients in whom aromatase expression was positive was still significantly higher than Group E but lower than that of Group B, although this difference failed to reach statistical significance (p=0.07).
Conclusion: The association of oral contraceptives with pinus pinaster extract and resveratrol was the most effective in inhibiting aromatase expression in the eutopic endometrium of endometriosis patients.